The clinic will typically implement a Cognitive Behavioural Therapy (CBT) program before considering medication as an option, as CBT is an effective treatment for selective mutism. Most of the children we have worked with at the Selective Mutism Clinic respond well to CBT by itself. However, there are some cases where medication has been indicated; for example, if there is concern that a child is also suffering from clinical Depression and their low mood is a barrier to them implementing the strategies that we have recommended. Children in the latter primary school years and high school often benefit from a combination of CBT and medication.
The medication prescribed in these instances is typically an antidepressant medication as these are effective at reducing anxiety, have the least side-effects, and are the safest type of medication to provide to children. Antidepressant medication typically acts by helping to reduce the child’s anxiety sufficiently to help motivate them to work on the behavioural strategies in the program. The emphasis remains on the child, the parents, and the school learning and practicing CBT strategies that they can continue using once medication has been ceased. In those cases where we feel that a child might benefit from medication, a referral will be made to a child psychiatrist or paediatrician, who will assess the child independently and liaise with the psychologist at the clinic.